10 Best Cashless Health Insurance Policy in India 2023 – Taxation and Cover
Cashless health insurance plans are policies that provide medical coverage to policyholders without requiring them to pay upfront for their medical expenses during the time of hospital treatment. Under these plans, the policyholder can receive medical treatment at a network hospital without having to self-fund the treatment up to the policy’s sum insured. The insurer directly settles the bills with the hospital, subject to policy terms and conditions. While the benefit of subscribing to such a policy is multi-fold, choosing the best cashless health insurance can be a tricky task.
Broadly, there are three types of cashless mediclaim policies in India – cashless individual health insurance policies, cashless family health insurance policies, and cashless senior citizen health insurance policies.
It is important to note that all medical expenses might not be covered under a cashless health insurance plan. Generally, pre-existing illnesses, cosmetic surgeries, and alternative treatments are not covered. Some standard coverages that usually are a part of cashless health insurance plans in India include pre- and post-hospitalisation expenses and in-patient care expenses among others.
Some insurers, like Navi Health Insurance, also offer daycare treatment cover for eligible treatments and even consumables – thus, offering a 100% cashless hospital bill cover.
Read on to find out which are the 10 best cashless medical insurance policies in India.
10 Best Cashless Health Insurance Plans 2023
| Cashless health insurance plans | Premiums |
| Navi Health Insurance | ₹235 per month onwards |
| Niva Bupa Health Insurance | Varies with the entry age and the sum insured |
| Apollo Munich Optima Restore Health Insurance | ₹24 per day onwards |
| Care Health Plan | Varies with the plan |
| ICICI Lombard Health Care Plus | ₹15.09 per day onwards |
| Bajaj Allianz Health Insurance Family Floater | Varies with the sum insured |
| Reliance Cashless Health Insurance Policies | ₹243 per month onwards |
| New India Assurance Cashless Health Insurance Policies | Varies with the plan. |
| HDFC Cashless Health Insurance Policies | ₹19 per day onwards |
| Aditya Birla Cashless Health Insurance Policies | ₹2,486 per year onwards |
How do Cashless Health Insurance Plans Work?
Cashless health insurance plans are popular in India as they allow policyholders to receive hospital treatment without paying for the services from their own pocket. Here’s how these plans work in India:
Most insurance companies offering cashless health insurance policies have a network of empanelled hospitals where you can receive treatment without paying cash from your resources. These network hospitals have a tie-up with the insurance company, and the insurer settles the medical bills directly with the hospital.
To avail of cashless treatment, the policyholder must be admitted to a network hospital. The policyholder should inform the insurance company or its third-party administrator (TPA) about the hospitalisation as soon as possible. The hospital will then contact the insurance company or TPA to get the pre-authorisation for the treatment.
Once the pre-authorisation is given, the policyholder can avail of the medical treatment at the hospital without having to pay anything, subject to policy terms and conditions. The insurance company settles the bills directly with the hospital. However, the policyholder might have to pay for non-medical expenses like food, toiletries, sanitizers, gowns, gloves, etc. with some insurers, or any expenses above the policy sum insured amount.
Insurance companies are always on the lookout to expand their network of hospitals nationwide to provide policyholders with access to medical treatment. The policyholder can choose any hospital from the list of network hospitals. The insurance company or its TPA will cover the medical bills as per the terms and conditions.
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Best Cashless Health Insurance in India – Detailed Overview
With its comprehensive coverage, unique benefits and affordable monthly premiums, Navi Health Insurance is an excellent option for individuals and families looking for the best cashless mediclaim policy in India. Insured members can enjoy 20-minute cashless treatment up to ₹1 crore at over 11,000 network hospitals and a 100% hospital bill cover including consumables expenses with no sub-limits on room rent charges. The policies also come with a 100% app-based and paperless process and affordable premiums starting at only ₹235 per month, making it an ideal option to cover medical emergencies and planned hospitalisations alike.
Key features of Navi Health Insurance
- Age: 91 days to 70 years
- Sum insured: Up to ₹1 crore
- Waiting period: As low as 1 year (terms and conditions apply)
- Minimum premium: ₹235 per month
- The policy covers 100% of the hospital bill (no sub limits on room rent charges, even consumables covered)
- 20-minute cashless claims at over 11,000 network hospitals
- 100% paperless onboarding and claim processes
- Pre and post hospitalisation cover from 90 days prior to 180 days after the hospitalisation
- Unlimited online doctor consultations
- Complimentary health checkup once every policy year
- Additional 100% sum insured for accidental injuries
- Cover for organ donor expenses
- Air ambulance cover up to ₹5 lakh
- Additional maternity benefit coverage up to ₹30,000 for up to 2 deliveries/lawful termination of pregnancy after a 3-years waiting period (on an add-on basis)
- Insurance top-up and porting facilities available
- With over 99.99% of claims settled within the first 3 months, Navi Health Insurance has topped the IRDAI claim settlement ratio list (private general insurance companies) for FY 2021-22.
2. Niva Bupa Health Insurance
Niva Bupa Health Insurance offers a range of comprehensive health insurance plans that ensure that medical emergencies do not disrupt the life plans of individuals and families. It comes with a strong network of 8600+ hospitals and promises a 30-min cashless claim process.
Key features of Niva Bupa Health Insurance
- Age: 18 years to 65 years
- Sum insured: ₹3 lakh to ₹45 lakh
- Waiting period: 30 days (2 to 6 years for pre-existing conditions)
- Minimum premium: Varies with age and the sum insured
- Pre- and post-hospitalisation and daycare treatment expenses are covered.
- Most plans come with a no-claim bonus benefit. If no claim has been made in a policy year, the insured receives a discount on premiums for the next year.
3. Apollo Munich Optima Restore Health Insurance
It comes with a range of attractive features that make it a good pick among health insurance policies. Optima Restore offers 100% restore benefits, complimentary health checkups, daily hospital cash, and more. A strong network of 12,000+ hospitals makes it the best cashless medical insurance in India.
Key features of Apollo Munich Optima Restore Health Insurance
- Age: 5 years to 65 years
- Sum insured: ₹5 lakh to ₹50 lakh
- Waiting period: Within 30 days for accidental hospitalisation; 2 to 3 years for other conditions
- Minimum premium: Starts at ₹24 per day
- Pre- and post-hospitalisation, day care treatment, organ donation, emergency ambulance expenses are covered under the plan.
- The policy comes with a lifetime renewal benefit.
- Under section 80D of the Income Tax Act, the insured can claim up to Rs. 75000 in deductions for premiums paid toward the policy.
4. Care Health Plan
Care Health Insurance Plan provides a range of benefits and features to policyholders, with over 21,100 cashless healthcare providers. Unlike many traditional health insurance plans, the Care Health Insurance Plan does not require policyholders to undergo medical tests for policy issuance. Some of its best health insurance plans include Family Floater, Youth Health Insurance, Senior Citizen Health Insurance, and Critical Illness Cover.
Key features of Care Health Plan
- Age: 91 days is the minimum entry age
- Sum insured: ₹3 lakh to ₹6 crore
- Waiting period: NA
- Minimum premium: Varies with the plan
- The policy covers pre- and post-hospitalisation, in-patient hospitalisation, domiciliary hospitalisation expenses.
- The policy covers coronavirus treatments, advance medical treatments, and AYUSH treatments.
5. ICICI Lombard Health Care Plus
ICICI Lombard Health Care Plus is a health insurance policy that comes with 6,700+ cashless healthcare providers. With benefits like free health check-ups every year, wellness programs, discounted premiums, etc., it is considered one of the best cashless mediclaim policies in India. Health AdvantEdge, Health Booster, and Arogya Sanjeevani Policy are some of the best healthcare plans under the policy.
Key features of ICICI Lombard Health Care Plus
- Age: 21 years is the minimum age to be eligible for the policy
- Sum insured: Up to ₹5 lakh for a mediclaim policy
- Waiting period: 2 years for pre-existing conditions.
- Minimum premium: Starts at ₹15.09 per day (for 21 years of age at the time of the issuance of the policy)
- Mediclaim policy covers only accident-related treatment, hospitalisation, and pre-specified medical conditions (up to a predefined limit).
- Health insurance policies cover pre- and post-hospitalisation expenses for 30 days prior and 60 days after hospitalisation.
6. Bajaj Allianz Health Insurance Family Floater
Bajaj Allianz Health Insurance offers a Family Floater policy that provides comprehensive coverage for medical emergencies and more for your entire family. This policy offers a fixed sum insured and covers you, your spouse, and your children. The policy offers several benefits, including lifetime renewability, portability, preventive health checkups, hassle-free claim settlement, and more.
Key features of Bajaj Allianz Health Insurance Family Floater
- Age: NA
- Sum insured: ₹1.5 lakh to ₹1 crore
- Waiting period: 30 days
- Minimum premium: Varies with the sum insured
- The Gold & Platinum Plan covers Ayurvedic and homoeopathic treatment for up to ₹20,000.
- Road ambulance charges are covered for up to ₹20,000 for every policy period.
- Pre and post-hospitalisation expenses are covered for 60 days before and 90 days after hospitalisation.
- The policy covers daycare procedures, bariatric surgery, and organ donation expenses.
7. Reliance Cashless Health Insurance Policy
Reliance Health Gain Insurance, offered by Reliance General Insurance, provides extensive coverage for medical expenses. It comes with several benefits, including reinstatement of the sum insured, cumulative bonus, extra sum insured, and more. With a network of 8600+ cashless hospitals, the policy offers a 6-day cashless claim period. Reliance Health Gain Insurance is a reliable and convenient solution for your healthcare needs.
Key features of Reliance Cashless Health Insurance Policy
- Age: 5 years to 65 years; the minimum entry age can vary with the plan
- Sum insured: Starts at ₹3 lakh (Varies with the plan)
- Waiting period: 30 days, 15 days for covid-19 treatment, and 2 to 3 years for other pre-existing conditions
- Minimum premium: ₹243 per month
- The policy covers pre and post hospitalisation expenses, ambulance expenses, in-patient hospitalisation costs, and domiciliary hospitalisation expenses.
- Organ donor expenses and other modern treatments are also covered under the policy.
- In case the insured is diagnosed with a critical illness, the renewal premium for that period is waived off.
- The premiums paid towards the policy are eligible for deductions under section 80D of the Income Tax Act.
8. New India Assurance Cashless Health Insurance Policy
New India Assurance is a leading health insurance provider in India that offers a range of health insurance policies, including cashless health insurance policies. These policies allow customers to receive cashless medical treatment at network hospitals across India without paying upfront.
Key features of New India Assurance Cashless Health Insurance Policy
- Age: Varies with the plan
- Sum insured: Varies with the plan
- Waiting period: Varies with the plan
- Minimum premium: Varies with the plan
- The New India Assurance Cashless Health Insurance Policy is designed to provide comprehensive health coverage for individuals and families.
- It comes with features, such as no pre-policy check-ups, hospital cash benefits in case of hospitalization, free preventive health check-ups once every three policy years, and coverage for additional medical expenses through top-up policies.
- New India Assurance also offers a range of other health insurance policies to cater to the diverse needs of customers.
9. HDFC Ergo Cashless Health Insurance Policies
HDFC Ergo has a network of 12000+ cashless hospitals and features several plans for individuals, families, senior citizens, and more. The policy offers several benefits, including recovery benefit, lifelong renewability, multiplier benefit, and uninterrupted medical coverage with the rebounding of the sum insured.
Key features of HDFC Cashless Health Insurance Policy
- Age: 18 years to 65 years
- Sum insured: ₹5 lakh to ₹2 crore
- Waiting period: NA
- Minimum premium: Starts at ₹19 per day
- The policy covers day care treatments, home treatments, mental health treatments, Ayush treatment, organ donor expenses, and hospitalization expenses.
- Pre and post-hospitalisation expenses are covered for 60 days before and 180 days after hospitalisation.
10. Aditya Birla Cashless Health Insurance Policy
Aditya Birla Cashless Health Insurance Policy provides cashless medical treatment to policyholders in case of hospitalisation at any of its 10,051+ network hospitals. Other benefits include comprehensive health check-ups, cashless home treatment, premium waiver, no claim bonus, discounted premiums, and more.
Key features of Aditya Birla Cashless Health Insurance Policy
- Age: Varies with different plans
- Sum insured: Starts at ₹5 lakh
- Waiting period: 30 days
- Minimum premium: ₹2,486 per year
- The policy covers pre and post-hospitalisation expenses for 60 days before and 180 days after hospitalisation.
- The policy covers expenses incurred on hospitalisation for the treatment of covid-19.
- Daycare procedures, Ayush in-patient treatment, and maternity expenses (depending on the plan) are covered.
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Benefits of Cashless Health Insurance Plans
1. Protects Savings in Times of Medical Emergencies
Medical emergencies can drain your savings in case you don’t have a proper financial plan, preferably an adequate health insurance protection covering all your dependent family members. However, if you opt for a cashless insurance policy, you need not pay anything out of your pocket for the treatment costs up to the policy sum insured. Note that a cashless facility is available only when you get treated at network hospital of your insurer.
2. No Urgency for the Arrangement of Cash
In case of medical emergencies and hospitalisation, arranging funds can become difficult. To avoid such a situation, one can opt for a cashless health insurance policy in advance to secure their financial future. This could also help you avoid going for an unnecessary and expensive loan.
3. Range of Coverage
These insurance policies provide coverage for pre and post hospitalisation charges, ambulance costs, expenses incurred for in-patient care, health check-ups, consumables and much more, depending on the chosen health policy’s terms and conditions.
4. Covers Medical Emergencies During Travel
There might be medical emergencies when you are travelling. In such cases, you might need to part with a significant portion of your savings. However, if you obtain one of the best cashless health insurance plans, you can get trusted services in case of medical emergencies from any network hospital and need not pay anything for the treatment costs out of pocket.
Factors to Consider Before Buying Cashless Health Insurance Plans
1. Sum Insured
The sum insured on your cashless health insurance plans varies across several insurance companies based on multiple factors including your location. For instance, the maximum sum insured for small cities could be relatively lower than that of metro cities.
2. Claim Settlement Ratio
You might expect a hassle-free and seamless claim process when it comes to health insurance policies. In this regard, you might want to check the insurance company’s claim settlement ratio before choosing a plan.
3. Network Hospitals
You can raise a claim against your cashless health insurance policy from network hospitals. Hence, you might want to consider an insurer with a wide range of network hospitals, especially including the top hospitals at your preferred locations.
4. Lifetime Renewability
Generally, you need to renew your health insurance policies to continue being a beneficiary, and the renewability is subject to certain restrictions. However, some of the best cashless health insurance schemes come with lifetime renewability.
5. Coverage Scope
You might want to ensure that your cashless health insurance policy includes essential coverage such as pre and post hospitalisation charges, maternity benefits, daycare costs, etc.
Advantages of Buying Cashless Health Insurance Plans Online
Given below are the advantages of purchasing cashless health insurance policies online:
1. Comparison is Easy
One can easily compare the health insurance policies of different insurers online. After weighing the pros and cons, individuals can purchase a policy that is best suited for their requirements.
2. Easy Transaction
Now, all that one has to do to purchase a health insurance policy is fill up a form, submit a few basic KYC documents, choose the required sum insured, choose add-on services if required, and make the premium payment.
3. No Middlemen
Interested members can undertake the health insurance policy onboarding process themselves without interference from insurance agents or middlemen. This reduces cost and makes the entire process quick and hassle-free. Some insurers like Navi Health Insurance offer a 100% app-based and paperless onboarding and claim settlement process.
4. Transparent Terms and Conditions
Insurance providers clearly list the terms and conditions of the policies on their official websites. Investors can go through them and make informed decisions before purchasing the insurance policy online.
5. Pre and Post Sales Services
Investors can avail many pre and post-sales services. They can use premium online calculators provided by insurance companies to compute their premium before the online purchase of a medical insurance policy. Live chat facilities clear doubts of investors. After the purchase, premium receipts and the soft copy of the policy bond are sent to the investor.
Insurance providers clearly list the terms and conditions of the policies on their official websites. Investors can go through them and make informed decisions before purchasing the insurance policy online.
Inclusions Under Best Cashless Health Insurance Plans
The inclusions of some of the best cashless health insurance policies are as follows:
- Pre and post hospitalisation expenses
- Emergency ambulance cost expenses
- Organ donor expenses
- In-patient hospitalisation expenses
- Domiciliary treatment expenses
- Expenses incurred for daycare procedures
- Value-added services
- No claim bonus
- Pre-existing illness
- Critical illness cover
- Free health check-ups
- Daily hospital cash allowance
Exclusions Under Cashless Health Insurance Plans
- Registration or admission fees
- Toiletries
- Attendant’s charges
- Service fees
- Costs of diapers, oxygen masks, syringes etc.
Factors Influencing Premium of Cashless Mediclaim Insurance Plans
Given below are the factors affecting the premium of a cashless health insurance policy:
1. Age
Young investors have to pay a lower premium compared to older people.
2. Gender
Premium rate could be different for men and women. This is because it is generally believed that women tend to take more precautions and preventive measures than men.
3. Profession
Premium charges will be higher if the investor works in an environment where he/she is exposed to hazardous chemicals, dangerous substances, and radiation.
4. Body Mass Index (BMI)
The Premium could be higher for people who have a high BMI, as the chances of having diabetes, cardiac problems and joint problems are high for these people.
5. Add-on Covers
Add-on covers or additional coverages are bought at an additional cost over and above the premium of the base insurance policy.
6. Family Medical History
Genes play an important role in deciding the function of human bodies. Hence, the premium charged will be higher if family members suffer from specific diseases.
7. Lifestyle
Individuals who have the habit of drinking, smoking, and chewing tobacco could have to pay higher premiums depending on the terms and conditions of the chosen policy. This is because there’s every chance of them developing cancer and cardiac problems.
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Eligibility Criteria for Applying for Cashless Health Insurance Plans
1. Entry Age
18 to 65 years (for adults), 90 days to 25 years (for dependent children)
2. Pre-medical Screening
Required for individuals above the age of 45 or 55 or 65 years, depending on the terms and conditions of the chosen insurer.
3. Pre-existing Disease Waiting Period
1 to 4 years
Steps to File a Claim for Cashless Health Insurance Plans
If you opt for the best cashless mediclaim policy for a family in India, you usually have to follow these steps for a successful claim process:
1. In Case of Planned Hospitalisation
- Fill up the claim form at a network hospital by providing necessary details about your or your family member’s hospitalisation.
- Submit the form to the insurance company or the Third Party Administration (TPA) along with valid ID proof.
- After approval, the insurer or TPA will notify the hospital regarding the claim amount.
- Finally, the insurance company will settle the payment with the hospital during the treatment and at the time of discharge.
2. In Case of Emergency Hospitalisation
- You need to intimate your insurer within 24 hours of hospitalisation at a network hospital.
- Send the claim form to the respective TPA or insurer for approval.
- After approval, they will inform the hospital regarding the claim and settle the payment on your behalf.
In this regard, you might want to consider the Navi Health Insurance policy from the insurance company as they can approve cashless claims within 20 minutes. Moreover, owing to their app-based processes, you can raise claims in a hassle-free manner. To avail of such benefits, you just have to download the Navi App and enjoy a seamless cashless facility with regard to health insurance plans.
Follow these steps to get cashless claims at network hospitals:
- Step 1: Visit a network hospital to avail of medical treatment.
- Step 2: Ask for a pre-authorisation form at the hospital desk. You can also download it from the TPA website.
- Step 3: Fill up the pre-authorization form and submit it at the hospital along with a valid ID proof.
- Step 4: TPA will scrutinise the form and sanction the treatment amount.
What are the Documents Required for the Cashless Claim Settlement Process?
Given below is a list of all the documents required for the cashless claim settlement process:
- Duly filled out a claim form
- Diagnosis reports
- Medical certificate
- Discharge certificate
- Valid ID proof
- Copy of FIR
Tax Benefits Under Cashless Health Insurance Plans in India
As per provisions of the Income Tax Act, one can seek tax deductions against the premium paid towards health insurance policies.
The table below provides the tax benefits that one can seek for different situations:
| Section | Deduction On | Maximum Amount of Tax Deduction |
| Section 80D | Premiums of health insurance policies | ₹1,00,000 |
| Section 80DD | Medical expenses incurred for a dependent disabled relative | ₹1,00,000 |
| Section 80DDB | Medical expenses incurred for the treatment of specified diseases | ₹1,00,000 |
| Section 80U | Healthcare expenses for a disabled taxpayer | ₹1,25,000 |
The premium you pay for cashless health insurance plans is eligible for tax benefits as per Section 80D, Income Tax Act. One can obtain benefits up to ₹25,000 if they are below 60 years, and for senior citizens, the amount is ₹50,000
Final Word
Cashless health insurance plans with adequate sum insured could be extremely helpful in protecting your savings and investment returns during medical emergencies. Insured members can enjoy a sum insured that is 100 times higher than the annual premium obligation. Besides, you could also enjoy substantial tax-benefits on the premiums paid. However, ensure you choose a health policy whose coverage and benefits are in line with your family’s unique medical requirements. And while you are in your quest for the best cashless health insurance plans in India, you might want to consider any of the plans in the aforementioned list. Of course, while we are on the subject of cashless health insurance plans, you may want to have a look at the benefits offered by Navi Health Insurance. Along with cashless settlement of claims under 20 minutes at 11,000+ network hospitals across in India, you get a number of other great benefits, such as 100% hospital bill cover, online doctor consultations, and more. Download the Navi App today to get started.
FAQs
Generally, cashless hospitalizations are perceived to be more convenient. One can get cashless claims at any network hospital. The insured person doesn’t have to run around arranging for cash or doesn’t have to go through the tedious process associated with reimbursement claims.
Generally, cashless health insurance policies come with a tenure of 1 year. This is the standard policy tenure. It needs to be renewed annually. However, some insurance providers offer a policy tenure of 2 years or 3 years, as well.
Investors can use a health insurance premium calculator which is an online tool to calculate the premium for a mediclaim policy. You have to insert your age, sum insured, policy tenure, and the number of family members to be insured to get the premium amount.
You can visit the official website of the insurance provider and check the list of network hospitals offering cashless treatment. You can also search for information related to network hospitals online.
You can choose from a number of health insurance plans in India, such as:
-Cashless health insurance for a family: You can get your family members insured under a single policy.
-Individual cashless health insurance: Only a single individual can benefit from this insurance plan.
-Cashless health insurance for senior citizens: Under this insurance plan, senior citizens can raise a cashless claim to cover hospitalization expenses, ambulance charges and more.
Yes, if you manage to maintain a claim-free year within your policy term, your insurer might offer you a No Claim Bonus. Under this bonus, you can get discounts on policy premiums. Alternatively, insurers might decide to increase your sum insured for a claim-free year.
Some insurers can offer insurance policies with a co-payment option. Here, the individuals might need to pay a certain percentage of the claim amount, and the insurance company will pay the rest. While choosing the best cashless health insurance policies, you might want to consider this factor.
Individuals can benefit from traditional health insurance policies only after 24 hours of hospitalization. However, with the advancement in technology, some treatments might require less than a day of hospitalization. Such treatments fall under daycare procedures. A cashless health insurance policy covers the costs associated with this kind of procedure.
A typical cashless insurance policy includes the following in-patient hospitalization expenses:
– Room rent
– Nursing
– Pre and post hospitalization expenses
– Costs of daycare procedures
– Ambulance charges
– Expenses related to domiciliary hospitalization
– Organ donation costs
Cashless health insurance allows the policyholder to get medical treatment without paying the hospital bills from their own resources. The insurance company has a network of hospitals where the policyholder can avail of cashless medical treatment. The insurance company directly settles the hospital bills with the hospital, and the policyholder does not have to pay anything up to the policy sum insured.
Cashless health insurance policies might not cover expenses related to cosmetic surgeries, infertility treatments, dental treatments, vision correction, and alternative treatments like Ayurveda, homoeopathy, etc. depending on the policy terms and conditions. Moreover, expenses related to self-inflicted injuries and substance abuse are not covered by cashless health insurance.
If a cashless claim is rejected, the policyholder can either opt for reimbursement of the medical expenses or appeal to the insurance company. In case of reimbursement, the policyholder needs to pay the medical bills from their pocket and then submit the bills to the insurance provider for a full or partial reimbursement after a few days or weeks, subject to the insurer’s terms and conditions.
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Disclaimer: This article has been prepared on the basis of internal data, publicly available information and other sources believed to be reliable. The information contained in this article is for general purposes only and not a complete disclosure of every material fact. It should not be construed as investment advice to any party. The article does not warrant the completeness or accuracy of the information, and disclaims all liabilities, losses and damages arising out of the use of this information. Readers shall be fully liable/responsible for any decision taken on the basis of this article.
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